When Y2K “year 2000” approached, many feared that computer programmes storing year values as two-digit figures (such as 99) would cause problems as the next number was “00”. Frequently, programme logic assumes that the year number gets larger, not smaller. So, “00” was anticipated to wreak havoc in a programme that had not been modified to account for the millennium. But Indian IT companies saw opportunity in the Y2K bug. After Y2K, the financial services also saw other regulatory compliances such as Sarbanes Oxley, Basel II, and a few others.

Come October 1, 2013, the U.S. will move from the ICD-9 system of disease classification to ICD-10 (International Classification of Diseases, 10th edition). It is a date set in by the Centres for Medicare and Medicaid Services (CMS). From that date forward, ICD-9 codes cannot be used to send claims and report services, and until that date, ICD-10 codes cannot be used. There is no grace period, and opting out is not an option. The transition to ICD-10 will significantly expand and change the codes the U.S. providers and payers have used for more than three decades, says R. Chandrasekaran, Group Chief Executive (Technology and Operations) of Cognizant.

The International Classification of Diseases (ICD) is a medical classification that provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or disease. Under this system, every health condition can be assigned to a unique category and given a code, up to six characters long. Such categories can include a set of similar diseases.

Despite the benefits of the coding conversion process, the cost and depth of its implementation have been compared to Y2K. The most important aspect of ICD-10 is that it has the potential to affect the entire cycle of care delivery. Some industry analysts call it “Y2K on steroids.” The transition was mandated so that the U.S. can catch up with the rest of the world. The ICD-10 system was issued in 1993 by the World Health Organization. The U.S., however, has not yet converted to ICD-10 and still uses the more than 30-year-old ICD-9 coding - a system that does not always accurately describe the diagnoses and inpatient procedures of current medical practice. ICD-10 will expand the number of available codes from 24,000 to more than 155,000.

Instead of ICD-9's three to five digits and predominantly numeric code form, ICD-10 contains up to seven digits and is alphanumeric. The ICD-10 implementation represents a massive overhaul of the medical coding scheme. Most healthcare stakeholders, including health insurers, hospitals, pharmacies, medical device manufacturers, and researchers, will face significant technical and operational challenges as they revisit systems and reconsider underlying business logic and processes that rely on ICD-9 codes. All of this will have to be done in time to meet the compliance date of October 1, 2013. This will generate ample opportunity for the Indian IT companies, according to K. Vinayambika, Senior Vice-President, Healthcare Practice, Cognizant. ICD-10 implementation has the potential to deliver a real return on investment for healthcare stakeholders since ICD-10 is far more meaningful for health management. There are varying projections on the estimated cost of ICD-10 implementation. The widely cited AHIP report for 2010 has estimated industry-wide cost of $2-3 billion.

Ms. Vinayambika said, “Healthcare insurance organisations, providers, software product vendors and governing bodies _ essentially all major entities in the healthcare industry _ will outsource in varying degrees. ”

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